SPECIAL EVENTS PERMIT PROCESS

Transcription

1 SPECIAL EVENTS PERMIT PROCESS o Apply no later than thirty (30) days prior to the proposed event. A late fee of $25.00 may be charged if the application is not timely filed. o Applications and all related correspondence will be reviewed by the Special Events Committee of the City of Republic. o Notification will be given within four (4) business days as to whether a permit will be required. o If determination is made that a permit is required, a planning meeting will be scheduled with the applicant and the Committee to develop a formal plan for the event. o Applicant may be required to submit additional information for the planning meeting. This will be due five (5) business days prior to the meeting or may be requested to be presented at the scheduled meeting. o Denial of any special event application will be given in writing. o Applicant may appeal the denial to the City Administrator within five (5) days following notification of denial. o The City Administrator shall give written notification of the final decision within seven (7) business days following the appeal. Please submit the following information for review: Completed/signed application Completed/signed Waiver of Liability Pedestrian traffic access plan Vehicular traffic control plan Life safety plan Street closure request (if applicable-obtained through Public Works)

2 SPECIAL EVENT PERMIT APPLICATION EVENT: Date(s) Requested: Name/Title of Event: TYPE OR PRINT ALL INFORMATION Day(s): Mon Tue Wed Thu Fri Sat Sun Location: Describe specific location, include a drawing/detailed site plan to include area used, entry and exits (if enclosed), parking, structure locations, bleachers, canopies, fences, displays, concessions, etc. See additional attachments* Description of Event (in detail including schedule of daily events): See additional attachments Admission fee/registration charged to participants? Yes; amount No Set up to start at (date & time): Event start time: Event end time: Cleanup completed (date & time): Person in charge (day of event): Home/office phone: Cell phone: Estimated daily attendance: Estimated total attendance: APPLICANT: Organization(s): Phone: Contact person: Day phone: Fax: Mailing address: Non-profit org? Yes; ID Number No Applicant declares all information submitted on this application is true and accurate. Applicant will immediately notify the Planning Department of any additions or changes that arise after application is submitted. Changes could result in denial or revocation of permit. On behalf of the above organization(s), and all members thereof, applicant agrees to abide by all policies, procedures, and instructions set forth or provided by the City of Republic, its staff, officers, and designated agents; and will also comply with all relevant local, state and federal regulations. Applicant s Signature Date Planning Department Use Only Application conditionally approved pending: Insurance documents Fees/deposits Application fully approved Application denied; reason:

3 EVENT NAME/TITLE REQUESTED DATE(S). EVENT ELEMENTS: Indicate with Y/N in the left column, whether your event will include any of the following elements NO TYPE OF ACTIVITY CITY DEPT NO TYPE OF ACTIVITY CITY DEPT Alcohol beer wine spirits/mixed drinks Live Animals Special Lighting Shuttle bus/mass transportation Amplified music/sound Parade on city streets/in public right-of-way Barbecue/open flame Casino games/bingo/drawing/lottery Car show Food/beverage preparation/service/vendors Carnival (attach detailed description) Retail sales booth(s) Circus (attach detailed description) Trade/craft show Live performance/concert (attach details) Tents/canopies (attach details-quantities&size) Public Dance Scaffolding/temporary structures (e.g.,stage) Use of venue dumpsters/trash receptacles Private security Dunk tank Posting of signs/promotional banners/etc. Electrical generators Skydivers/hot air balloons/aerial activities Exclusive use of city parking lot (attach details) Solicitation of funds Fencing Street closures (attach details & maps) Fireworks/pyrotechnics/lasers/rockets/etc. Race: Type Portable restrooms Media coverage Vehicles driven/parked in parks Other: Inflatables (jumps, etc.) Other: CITY SERVICES REQUESTED/REQUIRED: Indicate with Y/N in the left column, whether you require/request any of the following city services. Note: Fees may be charged for city services. NO TYPE OF SERVICE CITY DEPT NO TYPE OF SERVICE CITY DEPT Electrical hookup to City/venue power sources First aid on-site Additional trash services/receptacles Special park maintenance svs (see details) Street sweeping Other: Use of City park/recreation field/shelter/building Other: Traffic control by Police Other: Crowd control/security by Police Other: DEPARTMENT KEY: 1 PARKS 5 PW STREET 9 EMERGENCY MGMNT 13 FINANCE 2 RECREATION 6 PW WATER 10 PLANNING 14 OTHER 3 POLICE 7 PW WASTEWATER 11 BUILDING 4 FIRE 8 RECYCLING CENTER 12 ANIMAL CONTROL Applicant declares all information submitted on this application is true and accurate. Applicant will immediately notify the Planning Department of any additions or changes that arise after application is submitted. Changes could result in denial or revocation of permit. On behalf of the above organization(s), and all members thereof, applicant agrees to abide by all policies, procedures, and instructions set forth or provided by the City of Republic, its staff, officers, and designated agents; and will also comply with all relevant local, state and federal regulations. Applicant s Signature Date Return completed Special Event Application form, plus any additional attachments and information to: City of Republic, Planning & Development Department 204 N. Main Street, Republic, MO Tel: Fax: Forms must be submitted at least 30 days prior to event start date. Incomplete forms will not be processed.

4 GROUP/ORGANIZATION WAIVER AND RELEASE OF LIABILITY ORGANIZATION/GROUP NAME: EVENT NAME: EVENT DATE: ON BEHALF OF THE ABOVE ORGANIZATION/GROUP, I expressly WAIVE, RELEASE and DISCHARGE the City of Republic, its officers, agents, and employees or any other person from any and all LIABILITY for any death, disability, personal injury, property damage, property theft, or actions, including any alleged or actual negligent act or omissions, regardless of whether such act or omission is active or passive which may accrue to myself or members of my organization/group or our heirs in connection with our participation in the above-described event. I fully understand and acknowledge that the CITY OF REPUBLIC IS relying on my representation that I have authorization to sign this document and that I will provide all members of my group a completed copy of this Waiver prior to our participation. I expressly INDEMNIFY AND HOLD HARMLESS the City of Republic, its elected and appointed officers, agents and employees from any and all liabilities or claims made by me or my organization/group, my/our heirs, and any other individuals or entities as a result of any of my/our actions in connection with my/our participation in this event except for those claims arising from the sole negligence or sole willful conduct of the City, its officers, employees, volunteers, or other representatives. Such indemnification includes liability settlements, damage awards, costs and attorney fees associated with any such claims. I hereby certify that I have read this document, understand its content, and am authorized to sign this document on behalf of all members of the group/organization I represent. DATE:. SIGNATURE: NAME: TITLE: ADDRESS: Return completed Special Event Application form, plus any additional attachments and information to: City of Republic, Planning & Development Department 204 N. Main Street, Republic, MO Tel: Fax: Forms must be submitted at least 30 days prior to event start date. Incomplete forms will not be processed.

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